小鼠颈部同种异体心脏移植模型学习曲线分析  

Analysis of learning curve of mouse neck heart allograft model

作　　者：王辉[1] 刘一纬 刘圆 杨鹏杰 梁越 WANG Hui;LIU Yiwei;LIU Yuan;YANG Pengjie;LIANG Yue(Graduate School,Inner Mongolia Medical University,Hohhot 010110,Inner Mongolia,China;Department of Integrated Chinese and Western Medicine,Inner Mongolia Mental Health Center,Hohhot 010010,Inner Mongolia,China;Department of Thoracic Surgery,Inner Mongolia Hospital of Peking University Cancer Hospital,Hohhot 010010,Inner Mongolia,China;Department of Vascular Surgery,Inner Mongolia Autonomous Region Peoples Hospital,Hohhot 010017,Inner Mongolia,China)

机构地区：[1]内蒙古医科大学研究生院,内蒙古呼和浩特010110 [2]内蒙古自治区精神卫生中心中西医结合科,内蒙古呼和浩特010010 [3]北京大学肿瘤医院内蒙古医院胸外科,内蒙古呼和浩特010010 [4]内蒙古自治区人民医院血管外科,内蒙古呼和浩特010017

出　　处：《外科研究与新技术》2024年第1期7-12,共6页Surgical Research and New Technique

基　　金：内蒙古自治区自然科学基金项目(2019MS08117);北京医学奖励基金会一般项目(YXJL202007850351);内蒙古医科大学联合项目(YKD2022LH005)。

摘　　要：目的探讨小鼠颈部同种异体心脏移植模型建立的学习曲线特点。方法回顾性分析课题组行60只小鼠颈部同种异体心脏移植模型制备的资料,分别记录手术过程中移植总时间、受体准备时间、供体准备时间、动静脉套管制成时间、供体心血管连接时间,采用累积和(CUSUM)分析法及最佳拟合曲线获取各阶段移植手术的学习曲线中渡过学习期所需最小手术样本数。以学习曲线最长手术阶段的最小手术样本数作为界限将小鼠分为学习阶段组和成熟阶段组,比较各组手术时间及手术失败率的差异。结果60只小鼠完成颈部心脏移植,移植总时间为(119.80±43.17)min,受体准备时间为(76.43±26.46)min,供体准备时间为(29.85±9.82)min,动静脉套管制成时间为(32.10±21.62)min,供体心血管连接时间为(17.47±8.43)min。对CUSUM学习曲线进行拟合,采用三次方时拟合度最高,各阶段手术时间学习曲线所对应的最小手术样本数依次是受体手术25,供体手术19,动静脉套管制成29,供体心血管连接24,手术全过程25。以学习曲线最长的手术阶段(动脉套管制成)的最小样本数29为分界点分为两组,与学习阶段组相比,成熟阶段组移植总时间[(156.80±32.80)min对(85.06±9.45)min]、受体准备时间[(95.41±18.89)min对(50.94±7.45)min]、供体准备时间[(37.03±9.51)min对(23.13±2.95)min]、动静脉套管制成时间[(50.41±16.65)min对(14.97±5.74)min]、供体心血管连接时间[(24.38±7.16)min对(11.00±1.55)min],均明显减少,差异有统计学意义(P<0.01)。成熟阶段组手术失败率较学习阶段组明显降低(48.28%对9.68%,P=0.0013)。结论建立小鼠颈部同种异体心脏移植模型的学习曲线在各手术阶段略有差异,手术样本数达29以后技术基本成熟。手术技术成熟后手术时间及成功率都会有明显改善。Objective To investigate the learning curve of mouse cervical heart allograft model.Methods A retrospective analysis was conducted of 60 cases of mouse cervical heart allograft.The total transplantation time,recipient preparation time,donor preparation time,arteriovenous cannulation time,and donor cardiovascular connection time were recorded during the operation.Cumulative sum(CUSUM)analysis method and the best fitting curve were used to obtain the minimum number of animals required to pass the learning period in the learning curve of each surgery stage.The mice were divided into a learning stage group and a mature stage group with the minimum number of cases for the surgery stage with the longest learning curve as cut-off point,and the differences in operation time and failure rate were compared between the two groups.Results Sixty mice completed neck heart allograft.The total transplantation time was(119.80±43.17)min,the recipient preparation time was(76.43±26.46)min,the donor preparation time was(29.85±9.82)min,the arteriovenous cannulation time was(32.10±21.62)min,and the donor cardiovascular connection time was(17.47±8.43)min.A cubic CUSUM learning curve was best fit to the data.The minimum number of surgical cases corresponding to the learning curve of each surgery stage was 25 cases for recipient surgery,19 cases for donor surgery,29 cases for arteriovenous cannulation,24 cases for donor cardiovascular connection,and 25 cases for the whole operation.Taking the 29 cases for the surgery stage with the longest learning curve(arteriovenous cannulation)as cut-off point,compared with the learning stage group,the total transplantation time[(156.80±32.80)min vs.(85.06±9.45)min],recipient preparation time[(95.41±18.89)min vs.(50.94±7.45)min],donor preparation time[(37.03±9.51)min vs.(23.13±2.95)min],arteriovenous cannulation time[(50.41±16.65)min vs.(14.97±5.74)min],and donor cardiovascular connection time[(24.38±7.16)min vs.(11.00±1.55)min]were significantly reduced in the mature stage group(P<0.01)

关 键 词：小鼠颈部同种异体心脏移植 学习曲线 累积和分析法 最佳拟合曲线 

分 类 号：R[医药卫生]